Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Landall Clark Hathorn, MD

Individual provider Family Medicine Physician · NPI 1487755617

Landall Clark Hathorn, MD is a Family Practice in Flowood, Mississippi. Graduated from University of Mississippi School of Medicine in 2002, 24 years ago. Practices with St Dominic Medical Associates LLC, a 127-clinician group and accepts Medicare assignment. Licensed in Mississippi.

Years since qualifying
24
Trained at
University of Mississippi School of Medicine
Licensed in
MS
In the registry since
2006
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1050 River Oaks Dr Ste 100
Flowood, MS 39232-9564
Phone: (601) 200-4760
Fax: (601) 200-4742
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 18385 (MS)

Record details

NPI number1487755617
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedSeptember 26, 2006
Last updated in NPPESNovember 13, 2023
Certification dateNovember 13, 2023

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF MISSISSIPPI SCHOOL OF MEDICINE
Graduated 2002 (24 years in practice)
Group practice St. Dominic Medical Associates Llc — 127 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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